Ranibizumab retinal pigment epithelial

Pharmacodynamics. Since ranibizumab is delivered via an intravitreal injection, studies were undertaken to determine if the drug could cross the neural retina and access the subretinal space where the CNV lesions are located. A study in rhesus monkeys demonstrated that 25 pg in 50 pL of Fab antibody fragment diffused through the neural retina to the retinal pigment epithelial layer after one hour and persisted in this location for up to seven days (10). The half-life in the vitreous was 3.2 days. These data are consistent with the results of a pharmacokinetic study done by a noninvasive fluorophotometric method that showed that fluorescein-labeled ranibizumab disappeared from the vitreous with a mean terminal half-life of 2.9 days and a mean residence time of 4.2 days (11). 

Comparative studies Adverse reactions have been studied in 32 patients with exudative age-related macular degeneration who received standard fluence photodynamic therapy with verteporfin at baseline and months 3, 6, and 9 and ranibizumab 0.5 mg at baseline and months 1, 2, and 3 [5 ]. The main adverse reactions outcome measure was severe loss of vision (a loss of best-corrected visual acuity of at least 30 letters). There was no severe loss of vision due to ocular inflammation or uveitis. One patient had moderate loss of vision (of at least 15 letters). Three patients had mild/moderate uveitis. There were two serious ocular adverse events (a retinal pigment epithelial tear and a moderate reduction in best-corrected visual acuity). There were no systemic adverse events. 

Retinal pigment epithelium tears can complicate exudative age-related macular degeneration or its treatment. An 81-year-old woman with retinal angiomatous proliferation and pigment epithelial detachment had a retinal pigment epithelial tear 10 days after an intravitreal injection of ranibizumab [12 ]. 

Pece A, Isola V, Milan P. Retinal pigment epithelial tear after intravitreal ranibizumab (Lucentis ) for retinal angiomatous proliferation (RAP) associated with pigment epithelial detachment. Semin Ophthalmol 2009 24 210-3. 

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